مقایسه واکنش پاسخ به استرس در دو روش بیهوشی عمومی و بیحسی نخاعی در اعمال جراحی ژنیکولوژیک

Background: Stress response to surgery and anesthesia includes wide range of hematological, immunological and endocrinological changes that partially were known. We designed this study to compare 2 methods of anesthesia, general anesthesia (GA) and spinal anesthesia (SA) at T10 level on serum cortisol and C_reactive protein (CRP) level and white blood cell (WBC) count and its differentation, as some markers of stress response. Materials and Methods: This randomized clinical trial study was carried out on 56 females in ASA class 1 undergoing elective cystocel_rectocel repair surgery in Khorramabad Asali hospital in 2004. Patients divided into 2 groups, General Anesthesia (29 patients) and Spinal Anesthesia (27patients) at level of T10. WBC count and its differentiation, serum cortisol and CRP level were measured before and 12 hs after surgery. Data analysIs was done by SPSS software. Results: Mean WBC count in GA group was significantly higher than SA group in 12 hrs post operation time (PV=0. 04l). There was no significant differences between percentages of polymorphonuclears, lymphocytes, eosinophils and monocytes in pre and post operation time in two groups(PV>0. 05). Although the mean serum cortisol level in GA group was lower in preoperative time (PV=0. 000), but in 12 hrs later was significantly higher than SA group (PV =0.0003). CRP in preoperative (PV=O. 1) and post operative (PV=0. 18) time showed no significant differences between 2 groups. Conclusion: It seems that spinal anesthesia at T10 level effectively inhibited stress response to surgery and decreased release of cortisol and WBC count in post operative time and its effect is mediated by inhibiting impulse at spinal cord level.